Iron Levels

RDW = Red Blood Cell Distribution Width

Not sure why the Dx would mark that - range is 11 - 14.

13 is average, so I would say based on that she is low for an endurance athlete wanting to maximize her potential.

This topic has been covered by our local coaching circle and we have made great strides in understanding how and what iron levels to check for. Keep in mind, a doctor thinks a normal teenage girl has feritin levels of 10-15, when in reality and optimal level for endurance athletes is 40-50.

Just take a look at this thread, there is some phenomenal info to be had here:

http://www.network54.com/Forum/41349/message/1323296150/Iron+info+From+the+Distance+Super+Clinic

A Concerned Parent wrote:

There are numerous abbreviations on the page we were given of the test results. These all mean nothing to me. Next to the RDW 12.5, the doctor penciled in (iron) and that was the only note on the page.

Can someone advise what else to look for on this blood test result page, and/or explain what RDW is and how high 12.5 is??

It seems that your doctor obtained a CBC, or Complete Blood Count, on your daughter. This test measures number and size of red blood cells. It is not a direct measurement of iron, but is generally the first step in determining whether someone is actually anemic, or has low number of red cells, since iron is needed to make red cells.

RDW is the 'distribution width' of red cell sizes. The instrument used to do a CBC is able to generate a plot of red cell volume or size. A healthy, non-iron deficient person will have a quite uniform-sized population of red cells, and hence a normal RDW - and 12.5 is totally normal. An iron deficient person will have an elevated RDW, often something like 16 or 18 - as the bone marrow runs out of iron, tiny red cells will be cranked out, along with the older normal-sized ones that were made when there was still enough iron.

So, you have no need to worry about a 12.5. I think the doc's note just happened to be next to that figure and is not related to it.

Other numbers you want to look at are hemoglobin and hematocrit - these are measurements of the number of red cells in a given volume of blood - they will be low if the person is anemic. The MCV, or cell volume, is also a critical measurement - iron deficient patients will have smaller than average red cells, or a low MCV.

Many of these numbers can be tricky - they can vary with hydration and also with altitude and with training intensity. Because of this, many docs will also get an iron level and a ferritin - ferritin is very useful as it reflects storage iron in the bone marrow - it can let you know that you need more iron even if you have not yet totally run out and become anemic - so, it let's you intervene even when the CBC may still be pretty normal.

Hope this helps.

Anyone have any advice on how to get the iron (and ferratin levels) up? I heard that even on suppliments that your body will only absorb 20% of it. How can someone work to get their numbers up and keep them up? Can you eat red meat to get things up and if so how often should you be eating red meat in order to help boost things back to where they should be for a distance runner? Daily or weekly meals?

SD Coach - "what" blood item does your chart represent???

What injuries come from low iron levels???

Here is the chart I had copied down in my notes

0-10 Horrible/Dangerous (risk of injury triples)

10-20 Really bad (risk of injury doubles)

20-30 Bad

30-40 Ok

40-50 Good

50-70 Excellent

(This is an adjustment to 50+ for optimal performance...I had always heard 30 before this)

Steve Scott told us to have the Dr. test her ferritin not her hemoglobin.

The key here is most doctors will not, and frankly are quite stubborn about including the ferritin(spelling?) levels in the blood test. Additionally, many pediatricians are completely unfamiliar with what to look at for an elite adolescent teen that is running 35-70 miles a week, much less female athlete that hasn't had a menstrual cycle in 18 months. 50-60 is ideal, but is mostly assuming that the female body is going to run that number down as the level of training increases.

The symptoms of low iron levels with girls is not so much physical injury, as it is a debilitating chronic fatigue type of issue, especially when exerting the effort high level training necessitates. We encourage all of our female athletes to have their iron levels checked(detailed blood panel). In the last 2 years 100% have been under 30 in their ferritin levels, with most of those being under 20.

As far as treatment is concerned....rather than red meat alone, LIQUID IRON(can be found at health stores), is the best treatment we have found. DO NOT let your doctor simply prescribe prenatal vitamins, they simply don't work fast enough.

Hope this helps

So the chart is based on Feritin?

Good tip about the liquid iron. My 16 yr old daughter has been taking a minimal supplemental dosage in tablet form, but I'm going to look into the liquid iron. Thanks!

Thread Follower wrote:

So the chart is based on Feritin?

Sorry, TF..yes the numbers are based on ferritin levels.

I just posted this in another thread but this should answer most/all questions about iron and ferritin, as well as hemoglobin.

http://runningwritings.blogspot.com/2011/11/ferritin-hemoglobin-and-iron-deficiency.html

I haven't found anything (other than the hemoglobin level) to be of any use in a CBC, and ferritin isn't part of a CBC anyhow. A runner with low hemoglobin is indeed rare, but low ferritin is very common.

It's not always about Iron and Hemoglobin! Keep in mind that there are many other minerals that you need to run well and avoid exhaustion such as magnesium, zinc, copper, calcium, sodium, potassium, etc. A deficiency in any mineral is going to mess you up.

High iron levels lead to heart disease.

some crazy runner wrote:

It's not always about Iron and Hemoglobin! Keep in mind that there are many other minerals that you need to run well and avoid exhaustion such as magnesium, zinc, copper, calcium, sodium, potassium, etc. A deficiency in any mineral is going to mess you up.

+1

A company called Cercacor is selling a non-invasive blood monitoring device. Kind of pricey but worth looking at the claims made for the product. Brenda Martinez and Leo Manzano are using it. The company claims it monitors 9 important blood parameters.

cercacor.com

A product called Biostrap sells for $250 (you can usually get a 20% discount on the website) that will show your blood oxygen saturation. Biostrap claims to have the most advanced oxygen saturation technology using deep-probing red LEDs. I'm thinking that since oxygen saturation is the final result of optimal blood composition then that is all you need to monitor.

biostrap.com

I'm not affiliated in any way with either of these companies.